Abstract
An inaugural Venous Leg Ulcer Consensus meeting was held in Perth, Western Australia, on 6 September 2020. It was attended by a large number of Australia’s wound care leaders who endorsed the need for, and support of, a proposal to develop Clinical Practice Guidelines for the Prevention and Management of Venous Leg Ulcers under the auspices of the Australian Wound Management Association (AWMA). The guidelines will not duplicate existing resources, but develop an innovative Australian framework for care. The key aim in developing the proposed guidelines is to improve health outcomes for the Australian community by preventing venous legs ulcers and their recurrence and provide an evidence-based framework for their management.

Abstract
Leg ulcers are a common, debilitating and chronic condition, more prevalent in older people. As with most chronic illnesses and conditions, leg ulcers have a significant impact on the health system and the individual. As most leg ulcers are managed in the community, it is imperative that community-based practitioners have specific clinical expertise, skill and professional judgement to inform decisions about the ulcer aetiology, appropriate management and optimal client outcomes. The Royal District Nursing Service (RDNS) SA Inc. undertook an integrative literature review to examine the role of the district nurse (DN) and general practitioner (GP) in management of leg ulcers. The review concluded that, whilst there is some uncertainty regarding roles, the competent district nurse can independently assess and manage venous leg ulcers to achieve optimal outcomes for clients and support the already overburdened healthcare system.

Abstract
The prolonged and recurrent nature of venous leg ulceration can be a source of great frustration to client and clinicians alike. Venous ulcers may have a significant effect on a person’s quality of life and treatment of this condition generates a burden on healthcare systems. It is a challenge to assist people with these ulcers to adhere to treatment and to generate and maintain positive lifestyle changes so as to reduce the risk of delayed healing, ulcer recurrence and poor health.

The Leg Ulcer Prevention Program (LUPP) was designed around key elements which influence ulcer healing, promote chronic disease management, optimise recurrence prevention and, more broadly, are conducive to better health and wellbeing. The program sought to empower clients to take ownership of their chronic disease and participate in self-management activities to augment their formal care.

LUPP led to statistically significant improvements in client knowledge for ulcer aetiology, compression bandaging treatment, activity and exercise, nutrition, skin care and the need for compression stockings following healing. Statistically significant improvements in client behaviours were demonstrated in the areas of activity and exercise, skin care and compression bandaging.

The results of this research are of interest to clinicians and organisations who deliver care to people with venous leg ulcers or indeed any chronic disease. LUPP is an evidence-based resource for providing effective client education to improve client knowledge and behaviours and, in turn, promote better health and wellbeing.

Abstract
The Leg Ulcer Prevention Program (LUPP) is an evidence-based, multimedia client education package for people receiving care for a venous leg ulcer. The program is delivered in the home via the nurse’s tablet personal computer. LUPP aims to assist people to understand and adopt clinically effective leg ulcer treatment and better manage chronic disease risk factors. The program engages clients in the ownership of their ulcer and self-care activities, promoting wound healing and recurrence prevention.

To complement the evaluation of client outcomes when participating in LUPP, the nurse perspective was investigated. A nurse survey and focus group was undertaken to describe and explore the nurse experience and satisfaction with LUPP. Satisfaction with LUPP was found to be high. LUPP demonstrated success in improving client education practices and nurses facilitated positive health outcomes for clients. LUPP was perceived by nurses as a valuable tool to engage clients and themselves in the education of people with venous leg ulcers.

The LUPP: nurse perspectives on a multimedia client education package for people with venous leg ulcers.

Abstract
This research report outlines the findings of a sub-bandage pressure randomised controlled trial (RCT). The aim of the subbandage study was to estimate the difference between mean interface sub-bandage pressures of two multi-layer compression bandage systems during supine position, standing, exercise and recovery. This open-label, prospective, single factor crossover, randomised within person RCT was designed to measure the sub-bandage pressure difference in two compression systems in vivo to inform a current pilot clinical RCT that is comparing the effectiveness of a three-layer straight tubular (elastic) bandaging system with a short-stretch (inelastic) compression bandaging system in the management of people with venous ulceration (3VSS2008). In the sub-bandage in-vivo study the inelastic and elastic compression bandages were randomised to opposite limbs of 42 healthy adult volunteers. Sub-bandage interface pressures for both bandages were compared within person. Interface sub-bandage pressures varied between different activities but the mean difference in interface pressures between inelastic and elastic bandages was consistently at least 13mmHg. Stiffness was 7.3mmHg higher in the inelastic group (95% CI: 5.1 to 9.5). The estimated difference in amplitude of sub-bandage pressure between the bandages during exercise was 15.5mmHg (95% CI 12.2 to 18.9). We found in-vivo interface sub-bandage pressures varied with the type of bandage and activity phase. These baseline results will be useful to inform future compression bandage studies that plan to measure venous ulcer healing rates.